Efficiency Differences Across Levels 2 & 3 Health Care Facilities in Kenya

Abstract

With the enactment of the Kenya constitution 2010, devolution evolved which entailed the introduction of the counties. In the process, there are various reforms that have taken place in the health sector. One of the major reforms undertaken includes channeling of the resources directly to level 2 and 3 facilities. Therefore service delivery as a result of devolution becomes important and there is need to establish the level of efficiency in these facilities. This study examines the usefulness of Data Envelopment Analysis in establishing the level of efficiency among level 2 and 3 health facilities. These facilities act as the first point of entry by patients. The main objective of the study was to determine the levels of efficiency across the primary health facilities in Kenya. The study uses a sample of forty seven (47) health centres and forty seven (47) dispensaries across all the forty seven (47) counties in Kenya. The results indicate that the average technical efficiency among health centres is 68.8% which implies that on average the facilities should reduce their inputs by 31.2% without reducing the levels of outputs. In addition, 25.5% (12) health centres had efficiency scores of 100%. On the other hand, the overall average of technical efficiency among the dispensaries is 61% implying that on average the facilities has inefficiency utilized inputs by 39% without reducing the levels of outputs. Regression results from the sampled health centers and dispensaries across the country shows that immunizations and outpatients visits are positively related to both Constant Returns to Scale (CRS) and Variable Returns to Scale (VRS) efficiency scores.